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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM'VT Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD I AR0031987 <br /> Facility ID 7A0018188 <br /> Date Printed 1/28/2008 <br /> SANDOVAL, HUMBERTO RE : A ONE AUTOMOTIVE REPAIR <br /> A ONE AUTOMOTIVE REPAIR 321 N STANISLAUS ST <br /> <br /> <br /> OWNER : SANDOVAL, HUMBERTO <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0173160---Date ofInvoice : 1/25/2006 1111111111111111111IIININIII <br /> 1/25/2008 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/25/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 237.00 <br /> Payment Due Date 2/27/2008 <br /> TOTAL DUE this Billing Period $ 237.00 <br /> TIC< <br /> PAYMENT <br /> RECEIVED <br /> o-' ., 2 b aoa <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees For DES/HMMP Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% Penalties will be added at the Rate of 10 <br /> 30 Days after the Due Date 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> _>3 ml <br />